Central venous catheters are an integral part of modern medical practice and their advantages are beyond doubt. More than 20 million (over 50%) of inpatients in the USA received intravenous therapy every year (see, e.g., Maki D. Pathogenesis, prevention and management of infections due to intravascular devices used for infusion therapy. In: Bisno A, Waldvogel F. eds. Infections associated with indwelling medical devices, 2nd edn. Washington D.C.: American Society for Microbiology, 1994: 155-212; Raad I, et al., Infect Med 1996; 13: 807-812, 815-6, 823; Mermel L A. Ann Intern Med 2000; 132 (5): 391-402; each herein incorporated by reference in their entireties) and almost 5 million required central venous catheterization. However, there are approximately 250,000 catheter-related infections (CRI) and 120,000 episodes of catheter-related bloodstream infection (CR-BSI) annually in the USA (see, e.g., Maki D. Pathogenesis, prevention and management of infections due to intravascular devices used for infusion therapy. In: Bisno A, Waldvogel F. eds. Infections associated with indwelling medical devices, 2nd edn. Washington D.C.: American Society for Microbiology, 1994: 155-212; Raad I, et al., Infect Med 1996; 13: 807-812, 815-6, 823; Mermel L A. Ann Intern Med 2000; 132 (5): 391-402; Maki D, et al., Lancet 1991; 338 (8763): 339-43; each herein incorporated by reference in their entireties).
Data from the NNIS system (US) between January 1992 and February 1998 showed that BSI is the third most frequent nosocomial infection and accounted for 14% of all nosocomial infections (see, e.g., Richards M, et al., Infect Control Hosp Epidemiol 2000; 21 (8): 510-15; herein incorporated by reference in its entirety). BSIs prolong hospital stays from 7 to 21 days and account for an estimated increase in hospital costs of $3,000-40,000 per patient (see, e.g., Jarvis W. Infect Control Hosp Epidemiol 1996; 17 (8): 552-7; Pittet D, et al., JAMA 1994; 271(20): 1598-601; Haley R, et al., Am J Med 1981 70 (1): 51-8; Arnow P, et al., Clin Infect Dis 1993; 16 (6): 778-84; each herein incorporated by reference in its entirety). In addition, an estimated 10-20% attributable mortality owing to nosocomial CR-BSI has been reported (see, e.g., Jarvis W. Infect Control Hosp Epidemiol 1996; 17 (8): 552-7; herein incorporated by reference in its entirety).
In Europe, and according to the ESGNI-2 point prevalence study, 71% of all patients with BSI had an intravenous line (see, e.g., Bouza E, et al., Clin Microbiol Infect; 5: 2S1-2S12, 1999; herein incorporated by reference in its entirety). BSI accounted for 13% of all nosocomial infections in a Swiss 1-week prevalence study conducted in 1996 and the use of a CVC was an independent risk factor for infection [odds ratio (OR) 3.3] (see, e.g., Pittet D, et al., Infect Control Hosp Epidemiol 1999; 20 (1): 37-42; herein incorporated by reference in its entirety). In different European studies, BSI related to catheter infection accounts for 23.5-66% of all bacteremic episodes (see, e.g., Ronveaux O, et al., Eur J Clin Microbiol Infect Dis 1998; 17 (10): 695-700; Raymond J, et al., Infect Control Hosp Epidemiol 2000; 21 (4): 260-3; Valles J, et al., Clin Infect Dis 1997; 24 (3): 387-95; each herein incorporated by reference in their entireties). The increased cost per survivor in intensive care unit (ICU) patients with a BSI has been estimated at $28,960, with a 25% mortality (see, e.g., Pittet D, et al., JAMA 1994; 271(20): 1598-601; Pittet D, et al., Arch Intern Med 1995; 155: 1177-84; each herein incorporated by reference in their entireties).
As such, infection within placed catheters is a major problem. The art is in need of improved methods, systems, devices and kits for addressing this problem.